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European Radiology

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01-11-2015 | Musculoskeletal

Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment

Authors: Sébastien Touraine, Joël Damiano, Olivia Tran, Jean-Denis Laredo

Published in: European Radiology | Issue 11/2015

Abstract

Purpose

To investigate the efficacy of percutaneous chemonucleolysis using ethanol gel (PCEG) in alleviating radicular pain due to disc herniation after failure of conservative treatment.

Materials and methods

After failure of conservative treatment, PCEG was performed under fluoroscopic guidance in 42 patients with sciatica >4/10 on a Visual Analog Scale (VAS) for at least 6 weeks and consistent disc herniation on MRI or CT <3 months. The VAS pain score was determined at baseline, then after 1 and 3 months. We assessed the influence of patient-related factors (age, gender, pain duration) and disc herniation-related factors (level, migration pattern, disc herniation-related spinal stenosis) on outcome of PCEG.

Results

Mean pain duration was 6.7 months. Pain intensity decreased by 44 % and 62.6 % after 1 and 3 months, respectively, versus baseline (P = 0.007). A mild improvement was noted by the rheumatologist in 30/42 (71.4 %) and 36/42 (85.7 %) patients after 1 and 3 months, respectively, and in 31/42 (73.8 %) and 33/42 (78.6 %) patients by self-evaluation. Patients who failed PCEG were significantly older (49.8 vs. 37.3 years, P = 0.03). None of the other variables studied were significantly associated with pain relief.

Conclusion

PCEG may significantly improve disc-related radicular pain refractory to conservative treatment.

Key Points

• Percutaneous chemonucleolysis using ethanol gel (PCEG) is feasible on an outpatient basis.

• PCEG improves disc-related radicular pain refractory to conservative treatment.

• PCEG is feasible on an outpatient basis.

• Failure of PCEG does not interfere with subsequent spinal surgery.

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Title: Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment
Authors: Sébastien Touraine
Joël Damiano
Olivia Tran
Jean-Denis Laredo
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 11/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3740-1

At a glance: The STEP trials

Springer Medicine

Cohort study of lumbar percutaneous chemonucleolysis using ethanol gel in sciatica refractory to conservative treatment

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

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